Sub-Saharan Africa has the world’s smallest number of motorized vehicles but the highest rate of road traffic fatalities, with Nigeria and South Africa leading the pack.
The World Bank predicts that in the next two years, road accidents could be the biggest killer of African children between 5 and 15. By 2030, according to the Global Burden of Disease study, road accidents will be the fifth leading cause of death in the developing world, ahead of malaria, tuberculosis and H.I.V.
If you add to these numbers the injuries caused by violent crime and communal conflict, then you have all the ingredients for a public health emergency.
And yet, trauma receives only a tiny fraction of the attention and money given to these three infectious diseases. Every health care conference I attend focuses on vaccines, treatment and training to combat the infamous “triple epidemic.”
Over the last decade, billions of dollars have poured into Africa with the laudable aim of defeating these killer diseases. But that most basic killer, injury, remains neglected.
Part of the problem is that the solutions are so complex. It’s easy to quantify interventions like the number of AIDS-fighting anti-retrovirals or mosquito nets distributed. Pills can be counted, flown in on cargo planes and delivered to large numbers of people in a short time period. But a pill would do very little for someone on a rural road in Nigeria with a head injury and a collapsed lung.
We need to put in place systems to provide lifesaving care for accident victims. They need to be moved to a fully equipped hospital — one with X-ray machines, CT scanners, a burn unit — within the space of 45 minutes. We need at least 10 of these proper hospitals. We need to improve our roads, and we need a high-quality ambulance system to drive on them. And we need paramedic schools — like the one my company is helping to open, the first of its kind in Nigeria.
Some countries in other parts of the world have come up with proactive solutions. In Israel, a group called United Hatzalah helps volunteer emergency workers get quickly to accident sites, by “ambucycle” or on foot, if necessary. But Africa’s challenge will require an African response — and international support.
On the road that night, I quickly assessed that the young man needed urgent medical attention. I gave him oxygen and inserted a makeshift airway. I noted that he probably had internal bleeding and did my best to stem whatever external bleeding I could detect.
A passing taxi then transported him to the nearest hospital. He had a fighting chance. But too many injured Nigerians, forgotten on the side of the road, do not. It’s time the global public-health community paid attention to Africa’s urgent need for emergency medical care.
This brings back a memory of New Year's Eve, 1983. I was on my way with a colleague to a party in downtown Guangzhou, and our cab struck a bicyclist who came right through the windshield. After lying on the road for a time under my sports coat, he was picked up and carried into a bus and then to a hospital. The cops who showed up had no interest in us and sent us on our way.
I often wonder what became of that young man.