Deadly Roads Are Not Just a Metaphor
Published June 18, 2009 @ 09:15AM PT
(photo credit: richardmasoner)
Take a guess at the answer to this question: What kills 1.3 million people worldwide each year, 90% of them in developing countries?
The hot-button issues probably crossed your mind: AIDS, perhaps malaria. If you're a global health junkie (and regular reader of this blog), maybe you'd guess tuberculosis. When we think about large numbers of mortalities, we tend to think of the "big name" diseases. Editor's note: If you are a very diligent reader of this blog, you might already know the answer.
The answer, however, isn't even a disease, let alone one with a Global Fund and celebrity spokespeople to address it. It's traffic accidents. That's what kills hundreds of thousands of people in the developing world every year.
Earlier this week, the World Health Organization released its first Global Status Report on Road Safety. The statistics are chilling, especially considering how little international attention this issue receives. Very few countries have comprehensive road safety laws, and those that do rarely enforce them. Perhaps the scariest statistic of all: the WHO predicts that traffic fatalities will be the fifth leading cause of death by 2030.
Why doesn't road safety garner the same kind of developed-world sympathy - and aid dollars - that infectious diseases do? I've done a lot of thinking about this, particularly because road accidents have directly affected me and several of my friends in Africa.
The WHO statistics indicate, by any account, a bona fide public health threat. Yet it's rare to encounter any international NGOs working on the issue, let alone idealistic aid workers trucking off to new parts of the globe to fight for better seatbelt laws instead of HIV medication.
A few thoughts:
- Road accidents happen at home, too. A car crash doesn't seem exotic to an American in the same way that many tropical diseases do. I'm not trying to undermine the importance of prevention and treatment for infectious diseases, but sometimes the ordinary problems don't seem as noble to fix.
- We can't deliver a commodity to treat it. As a donor, it feels good to imagine your money putting a tangible object in somebody's hands: an anti-malarial bednet, a nutritional supplement for a child. We can't prevent car accidents with a deliverable product.
- Addressing the problem means uncovering many, many more. Road safety in poor countries is a result of many complex, interconnected factors - safety standards for vehicles, unenforced traffic laws, shortages of trauma centers. A drug can't cure it.
Take a look at the WHO report and let me know what you think. Where do we start?
Share this Post
Facebook
Twitter
Digg
StumbleUpon
Delicious
EmailRelated Posts
-
Recommended Readings: June 16, 2009
-
Weekly Highlights May 31- June 6
-
Recommended Reading, May 28, 2009
Comments (12)
Comments on Change.org are meant for further exploration and evaluation of the ideas covered in the posts. To that end, we welcome constructive comments. However, we reserve the right to delete comments that are offensive, abusive, or off-topic; that contain ad hominem attacks; or that are designed to subvert or hijack comment threads rather than contribute to them. Repeat offenders may be permanently removed from the site at our discretion.
Author
-
Mara Gordon has worked in public health in Tanzania and in Botswana, and is currently in graduate school back in the United States. She originally from Washington, DC.
Featured Global Health Actions
-
-
Know your status- Get tested!
101 People
-
Know your status- Get tested!
-
-
Discrimination is Intolerable
209 People
-
Discrimination is Intolerable
This is a great post, and I think really opens it up for a discussion about our motives behind "doing" global health. Probably half the people I worked with at my last job complained of old injuries (or needed to be taken to the hospital because of new injuries), usually from being hit by something while working or begging, though once I watched one of my TB patients fall off a motorcycle. Anyways, point is, I guess I just had to accept that as a given, because what was I going to do (personally), ask everyone we worked for to stay away from the roads? Improving road conditions, city planning, enforcement of lights or even enforcement of pedestrian zones ("footpath" is a bit of a misnomer in most of India) are all way beyond the scope of any project I can conceive of working on, and honestly, are simply things that I don't think interest me. I'm interested in the "sexiness" of TB treatment and IMCI, and though I still believe I do it because I do want to improve people's lives, it is kinda hard to admit (but true) that maybe I'm not working on the things that should have the biggest impact. Anyways, what do other people think about limiting the definitions of "health" to only things that we personally care about?
Posted by Patrick Mayne on 06/19/2009 @ 10:37AM PT
You must be signed in to report content.
I keep thinking about that period when we had a gasoline shortage, and (I think it was during the Carter administration) the maximum driving speed on federal highways was lowered to 55 mph to save gas. One of the unintended consequences was that auto accidents and injuries decreased, which makes sense, of course. But as a nation we seem to put individual freedom in much higher regard than we do the well-being of all of us.
In another similar vein, I recently heard an NPR interviewee from Britain say that Europeans look at issues differently from Americans. The example he gave was that if an American hears that a big car is more likely to withstand the impact of a car crash, Americans think the big car is safer. If a European hears the same information, the European thinks big cars are the problem and, thus, are not safe.
Posted by Kendra Mon on 06/21/2009 @ 12:13PM PT
You must be signed in to report content.
Amazing how, as usual, Change.org leads this discussion directly into a plug for more government intervention. Perhaps one of the reasons that road safety does not "garner the same kind of developed-world sympathy - and aid dollars - that infectious diseases do" is that traffic accidents are almost completely avoidable, in any country. I've personally driven hundreds of thousands of miles in "traffic lawless" regions, like Latin America, Asia, and Eastern Europe, and have never even had so much as a fender-bender. A responsible driver can avoid accidents, except in extremely rare cases. Furthermore, traffic laws will not significantly reduce the fatality rate; they will only serve to increase government corruption and tax (via traffic fines) those that can least afford it -- the poor. Traffic fines represent the most regressive form of taxation, ever.
Now, what will reduce fatality rates are:
1) Improved infrastructure
2) Improved emergency response
3) Improved safety features of vehicles
As one can see from the following link, the U.S. traffic fatality rate has declined markedly over the 1983 - 2003 period, even as highway speed limits have been raised almost nationwide.
http://www.saferoads.org/federal/2004/TrafficFatalities1899-2003.pdf
Finally, it's worth noting that most accidents occur in the developing world because there are more people in the developing world. Take 42,000 accidents per 305 million people in the USA, and extrapolate that to a 6.2 billion world population, and suddenly 1.3 million doesn't seem like such an extraordinary number, but it still could be reduced by addressing the three issues above. That will happen only when free markets and free trade allow wealth, and related safety benefits, to spread worldwide.
Posted by Adam Cohen on 06/21/2009 @ 03:03PM PT
You must be signed in to report content.
I suspect the focus on vehicle infrastructure is misguided. I think what will reduce road accidents is better public transport.
Posted by Alanna Shaikh on 06/21/2009 @ 08:23PM PT
You must be signed in to report content.
While traffic fines may not be that helpful, clearly all three of your solutions would involve some degree of government intervention to be effective, Mr. Von Mesis. And your anectedotal account of how you pulled yourself up by your own safety belt and became a good driver doesn't count for much, either.
Posted by dan wolfe on 06/22/2009 @ 11:29AM PT
You must be signed in to report content.
Ok, I'll concede that some degree of government intervention might be helpful to improve road/highway infrastructure, but only because this area has historically been managed and administered by government. In fact, this is precisely why it is so inefficient, and traffic congestion is endemic in most cities worldwide. Once wealth increases in the developing word (via free markets and private property guarantees), public works will improve automatically, since related corruption will become less endemic (a $1,000 bribe goes a long way in a country where the average monthly salary is $200). In the meantime, my suggestion would be private aid/charities to build pedestrian bridges/crossings, vastly improve all road signs, and create educational campaign for everyone via conspicuously visible warnings at locations known for high accident rates. Government intervention would be required only in as much to allow these initiatives to do their work.
Posted by Adam Cohen on 06/23/2009 @ 07:46PM PT
You must be signed in to report content.
This is also an equity issue as the people who get killed are often pedestrians and cyclists and public transport users, ie the poorer people. It is not only an issue of enforcement of laws (although that is also important) but also of infrastucture - good physically protected footpaths and cycle lanes, well planned bus stop facilities, speed bumps / ramps to reduce speed. Sometimes it is more effective to enforce rules with infrastructure than with laws in environments where police and justice system have huge problems of corruption and inefficiency.
Posted by Elaine Baker on 06/22/2009 @ 01:52AM PT
You must be signed in to report content.
Road accidents in Uganda,are at the pick. If there is any study to do Uganda is the place to go.
Look for statistic from independent humane rights organizations, the government is quick at faking anything.
We need to work together to find lasting solutions that will save our people from the increasing danger from road accidents.
Good luck in this venture.
Michael Mutagubya.
Uganda.
Posted by Michael Mutagubya on 06/22/2009 @ 11:59AM PT
You must be signed in to report content.
In America 17 THOUSAND people die EACH year to drunk drivers. this does not include the injuried. just fatalities.
Having lost my only daughter to TWO underage drunk drivers & supporting thousands of others who have lost their children to the insanity of drunk driving- i am convinced the only put to come close to ending drunk driving is to instal a sophisticated inter-lock device on all vehicles.
we are long past the discussion of stricker laws. even if they did work (which they dont) after the DUI defence attorney's get done with plea deals.... most drunk drivers that kill end up doing around 18 months (if that) jail time.
get out, drink & drive again.
we made it mandatory for all cars to have seatbelts to save lives- why wouldnt we do the same with inter-locks?
Pam Taylor
Posted by mom_of Kelli on 06/24/2009 @ 03:40AM PT
You must be signed in to report content.
There are many solutions to road traffic injuries - engineering, education, enforcement, emergency medical services - and what we need is the public and political commitment to address these preventable deaths and injuries around the world. This is clearly a public health, transportation, economic, and humanitarian issue. Let's urge the UN to endorse a Decade of Action for Road Safety. See what many of us are doing to try to make a difference at: www.makeroadssafe.org (and join the Make Roads Safe Campaign for Global Road Safety!)
Posted by Bella Dinh-Zarr on 06/29/2009 @ 10:39AM PT
You must be signed in to report content.
I started a list of organizations that are working on these issues - I am sure there are more - but here is to starting!
It is wiki style - so you can add or remove based on your knowldege:
http://www.aboutus.org/best-sites/Accident/Car/Prevention
Best, Mark
Posted by Mark Dilley on 07/06/2009 @ 03:00PM PT
You must be signed in to report content.
Very interesting question indeed. Traffic accidents are another cause worth fighting for due to all the people who die like this every year. How come I've never thought about that?
Here in Mexico, streets are a complete chaos and people die all the time. There is no such thing as a road safety culture. Road etiquette is more like the law of the strongest one, in this case, the law of the one with the biggest vehicle (e.g. a Lincoln Navigator or a bus). You see people jaywalking the highway under a pedestrian bridge all the time! And I'm not afraid to admit it, I have repeatedly sped at 160 km/h in the urban highway, and yet I've never got a single fine. And this is in Guadalajara, where people still have some civility behind the wheel... in Mexico City, it's not rare to see like 5 cars honking at you because you stopped at a red light instead of skipping it...
Posted by Acoyani Garrido Sandoval on 08/31/2009 @ 11:26AM PT
You must be signed in to report content.