The road ‘kill’ factor

It has been projected that, by 2020, road traffic deaths will rise 60% worldwide and 80% in Africa. The World Health Organisation (WHO) predicts that road traffic injuries will rank third among causes of disability-adjusted life years lost. The road traffic injury death rate is highest in Africa (28.3 per 100 000 population compared with 11.0 in Europe.

Another source claims there are 1.7 deaths per 10 000 vehicles in high-income countries which average 60 licensed vehicles per 100 inhabitants, compared with more than 50 deaths per 10 000 vehicles in low-income African countries - where a figure of less than one licensed vehicle per 100 inhabitants has been recorded. Fleet growth is a contributing factor, perhaps explaining the 400% increase in road deaths in Nigeria between the 1960s and the 1980s.

Estimates are that in Africa, 59 000 people died in road traffic crashes in 1990, and this figure will be 144 000 by 2020, a 144% increase. However, the same model predicts a 27% reduction in high-income countries.

‘I think that witchcraft is one of the factors that causes accidents in our roads. You may find that I buy a new car and my neighbours are not happy about that, they are going to bewitch me so that my car gets destroyed and may even kill me. Sometimes you may find some stick (dikotana) in the morning in the car and you get an accident the following day, it shows that they worked, those sticks so that you get involved in an accident.' (Driver, South Africa)

Who is most at risk?

Twenty-four studies have shown pedestrians to be the most frequently injured road users in Africa, with the largest share of deaths in most countries (more than 40%).

Passengers are the second-most vulnerable (more than 30% of road deaths) and drivers account for a small share of fatalities (less than 10% in most countries). Only Botswana, South Africa and Zimbabwe show more than 20% of driver deaths.

In developing countries males, in particular, become involved in road traffic crashes and account for more than 67% of those killed (females tend to have a higher percentage of pedestrian involvement). More than 75% of road casualties are in the 16 to 65 age bracket. Children are often injured as pedestrians.

Types of vehicles involved

Various studies show a higher crash involvement of buses, minibuses, lorries and trucks than cars. Pedestrians are often doubly at risk because they are most likely to also use these forms of transport.

Why road accidents happen

Reports show that most road crashes in Africa are due to:

• Human error, including speeding, perilous overtaking, alcohol and drug abuse, driver distraction such as speaking on cell phones, and poor driving standards;
• Vehicle overloading and poor maintenance;
• Bad roads and terrain; or
• Pedestrian negligence.

Most studies rate the human factor as the highest contributorto road accidents. In a study among 23 European countries andin two African studies, vehicle factors came second, followed byenvironmental factors.

‘...witchcraft ...There are times when a driver can cause an accident claiming he sees a cow in front but passengers do not see that. Or a fly will just enter into the vehicle and even if you try to kill it (by doom and others) it will not die. It will go to the driver and start flying in his eyes and an accident may occur.' (Passenger, South Africa)

The human factor

According to the South African Department of Transport, driver factors accounted for between 80% and 90% of road crashes and deaths, vehicle factors between 10% and 30% and road environment factors between 5% and 15% in 2001.

Risk perception: ‘African perception of the risks of road traffic injury must be understood in order to be able to adapt and apply prevention campaigns that have proved successful elsewhere.' Cultural influences may contribute, as another research report pointed out on the basis of results from the Ivory Coast where professional drivers expressed an especially high degree of fatalistic beliefs. A South African study, found fatalistic beliefs in 16% of black and 21% of white drivers, and there was a significant relationship between a non-fatalistic attitude and seat belt use. South African taxi drivers showed largely fatalistic attitudes and expressed a high degree of risk-taking behaviour.

Excessive speeding: Data from police reports show speed as the leading cause of road traffic crashes, accounting for up to 50% of all crashes. Similar results were found in high-income countries. Alcohol and drug use: Studies in Africa showed that drivers had consumed alcohol in 33% to 69% of crashes in which drivers were fatally injured; and in 8% to 60% of crashes in which they were not fatally injured.

 In South Africa, almost 60% of fatally injured pedestrians had drunk alcohol. And one study found in a Durban hospital emergency unit found that drivers were most commonly intoxicated with alcohol while pedestrians often used both alcohol and cannabis (dagga). Research by the South African Department of Transport found that the national daily average of persons driving under the influence of alcohol had increased from 1.8% in 2002 to 2.1% in 2003.

Lack of information / training / licence: The South African Department of Transport found in a 2003 study that 16.5% of truck, bus and minibus taxi drivers had no driver's licence. A study done in Nigeria found that 38.8% of Nigerian commercial motorcyclists had no driving licence. In South Africa, 89.2% of university students and 63.2% of Cape Peninsula high school students drove without licences.

Driver fatigue, stress and aggression: Commercial and public road transport drivers in African countries often work long hours and go to work exhausted. Truck drivers in the KwaZulu-Natal Midlands work on average 16 hours a day. Falling asleep at the wheel has been implicated in 24% of heavy-vehicle road accidents in South Africa.

Another study showed that professional drivers in South Africa are often guilty of aggressive driving.

Table: Causes of accidents: driver fatigue, stress and aggression

Lack of seatbelt use: Around 99% of drivers in Kenya and 50% in Nigeria did not use seat belts. Use was lower among passengers, particularly rear passengers and child restraints were hardly used.

Lack of helmet use: A 2004 research report showed that failure to use a helmet resulted in more severe injuries among riders of motorcycles and was also an increased risk factor among cyclists.

What can be done?

Wider public education is necessary. Speed limits need to be strictly enforced and the use of traffic-calming strategies such as speed bumps and speed strips intensified.

Setting and enforcing legal blood alcohol limits and minimum drinking-age laws, using alcohol checkpoints and running mass media campaigns is essential. Mandatory seat belt laws, public education on the benefits of seat belts, and legislation on the availability of functional seat belts in vehicles are urged. Similarly, legislation and enforcement of the use of helmets are urged. Bicycle lanes, safety programmes, skills training and visibility-enhancement measures are advocated for cyclists. Provision of walkways, safe pedestrian crossings and traffic calming measures would help protect pedestrians.

Passenger safety can be enhanced through protection of the labour rights of bus and minibus drivers and by regulating their working hours. Speed should be checked by speed governors. Overall, what has been found effective in a high-income setting may not necessarily work in a low-income country. Some modification of road safety measures may be needed to see success in Africa.

This is an edited extract from a chapter in Peltzer, K. (in print) Road use behaviour in Africa, in Porter, B.E. (Ed.) Traffic and transportation psychology. Amsterdam: Elsevier.

Professor Karl Peltzer is a director in the Social Aspects of HIV/AIDS and Health research programme.