Some years ago I taught basic road engineering to a group of largely uninterested third year engineers. Attempting one morning to shake them out of their sleepy stupor I asked: “So, how many of you have lost someone in a road traffic crash?” The air chilled as about half of the class slowly raised their hands and fixed me with their now alert and pained eyes. How to respond to such a show of personal tragedy?
Today’s opinion pieces in The Cape Argus by Hector Eliot of the “Safely Home” road safety campaign and Sebastian van As of Red Cross hospital reminded me of this and sent me scrabbling for my notes from the recent Global Road Safety Partnership seminar around the subject of child road safety in Africa, held at the Southern Sun Hotel in August. The first morning of the seminar was awash with data:
- Africa has 2% of the world vehicle fleet….and 16% of the world road fatalities (Dr Olive Kobusingye)
- 17,000 were killed on South African roads in 2009. 2 x world average and 2.75 x UK average (Hector Elliot)
- Over one weekend at Red Cross Hospital 20 children under the age of 12 were admitted with road traffic-related trauma (Dr Sebastian van As)
Few realise that road traffic incidents are the second largest cause of death amongst children worldwide, and the leading cause of death for teens. Young children in low and middle income countries are most at risk, and in Africa a child is at least twice as likely to die in a road traffic incident as a child in the US, and four times more likely than in high income Europe. (This is despite the much higher car ownership in the high income countries). For every child that dies there are about seven more who face severe injury. Of those who are affected the majority – about two thirds – are pedestrians.
The two groups disproportionately affected by road crashes, then, are children and the poor, which makes road safety both a poverty and an equity issue, as well as a personal tragedy. One delegate noted: “if you weren’t poor before the road traffic crash, you will be afterwards”, as death and injury places financial and emotional burdens on already stretched families. Numbers, especially numbers about tragedy, can numb. Some delegates attempted to put them into perspective. The annual estimated worldwide death from terrorism, said Red Cross Hospital trauma surgeon Sebastian van As, is 5,000; from armed conflict is 370,000 and yet from road traffic incidents in 1,400,000. Despite its extraordinary scale the mundane regularity of child death on roads has made it, for the most part, media-unworthy. Only incidents of high profile figures, such as the loss of Nelson Mandela’s great-grand-daughter Zenani on the eve of the World Cup bring the matter into brief spotlight.
The delegates became most alert when individuals recounted their personal experiences. Sebastian van As told of a typical weekend at Red Cross Hospital when he would see 20 children who had been involved in traffic incidents. Van As has the near impossible job of breaking life-changing news about road incidents to families. This surgeon, saddened by what he describes as the most profound – but largely silent – humanitarian disaster of our time has taken up arms in the road safety cause. His particular bugbear is the use of seatbelts. This is such a simple measure and yet one neglected by the majority of South African parents, who think that they can restrain a child on their laps during a crash. The reality is that a 10kg child becomes the equivalent of four rugby locks during impact and no parent, no matter how loving or desperate, can hold onto that. Children fly through windows like bags of rice and their flesh is shredded by glass en route.
In light of the weight of evidence about road injury and death the United Nations woke up to the need for change and announced 2011 to 2020 as the Decade of Action on road safety. The Cape Town seminar noted, though, that despite this UN road incidents remain stubbornly high, especially in Africa. To learn that the Decade of Action has so far yielded disappointing results was disappointing but there were also real shoots of hope over the two days. Striking were the multiple stories of corporate support for the ‘scholar patrols’ which safely marshal children across high-speed roads. The Road Safety 4 Youth work (an example of which is in Belhar) which uses the creativity of youth to question drunk-driving also impressed. The road safety campaign spearheaded by Ugandan youth to use their rightful feelings of anger for powerful good also inspired. Less remarkable were the reactions of the State. For the most part their responses to this Decade of Action have been modest.
Concluding the two days surgeon van As urged for something more. The young shoots of change, inspiring as they were, appeared vulnerable and dwarfed in the face of this gargantuan problem. “We need”, urged van As, “a Treatment Action Campaign for road safety. Something which can raise the profile of this issue, as the TAC did for HIV/AIDS.” The question of where this ’TAC’ would come from was left hanging, although van As argued for more co-operation and partnership. Morsli, a delegate from of Algeria told of women worldwide who are starting to embrace social media as a platform for bringing together disparate bereaved families, and their campaigns of anger and grief. Through this mutual support they are better able to marshall resources to protest, raise awareness, and lobby for change.
These inputs reminded me of Peter Norton’s book “Fighting Traffic” which describes in detail the early days of motoring in the US and the clashes of interests and power which accompanied it. He tells of grieving mothers and children who, in the early part of the last century, formed lobby groups against speeding. Streets had, after all, been safe domains for children up until the arrival of the motor car. In New York in 1922 a procession of ten thousand children protested on the streets for their friends who had been killed by accidents (mainly traffic). Two hundred mothers also wore white stars in remembrance of the dead from the previous year. In 1922 the city of St Louis unveiled a monument “In Memory of Child Life Sacrificed on the Altar of Haste and Recklessness” and cherubs around the base of the monument told of the innocence of lives lost. In 1919 in Detroit the Safety Council’s campaigners tolled bells throughout the city eight times on any day a life was lost in a traffic ‘accident’.
That loss and tragedy can be transfigured into a profound force for good was an insight which was largely missing from the seminar. As I left the glossy towers of the Southern Sun I reflected that the sparks needed to fire up the existing powder keg of good will and good work into a firestorm that no politician can ignore would more likely come from bereaved parents than safety professionals. Social networks (both digital and traditional) of the youth and women may have the potential to link the scattered losses of grief and to create more powerful forces for change.
Another force for change are the individual realisations that ‘traffic accidents’ are, paradoxically, not accidental. An ‘accident’ implies that there is nothing which can be done to stop them but that’s far from the truth. There is much that can be done. One key is to slow down when driving, especially in areas where children roam. There is no escape from the reality that speed kills, and every country in the world which has succeeded in reducing road deaths has a culture of mindful, slower driving. The most immediate change for individuals, though, is to strap in your precious cargos of children. Whether they are in the front or the back of the car, without seatbelts you hold a gun to their heads every time you drive.