At 40 pct, bodaboda carnage calls for review of helmet law- experts

18Jul 2016
James Kandoya
The Guardian
At 40 pct, bodaboda carnage calls for review of helmet law- experts

Do you know the cost of riding a motor-cycle without a headgear? If you don’t listen to what medical experts talk about it.
At least five casualties of motor-cycle road crashes who are treated at the Muhimbili Orthopedic Institute (MOI) suffer permanent mental disabilities every month.

A victims of head injuries resulted from motorbike crash, Hamad Mohamed, 36 years a resident of Mbagala in Temeke Municipality admitted at Muhimbili Orthopedic Institute (MOI).

Only in April this year, for example, 15 casualties suffered temporary mental disabilities related to motorcycle road crashes, according to Medical Records Department officer at (MOI), Joshua Alein when interviewed by ‘The Guardian’.

In the same month, five people suffered permanent walking disabilities (amputation) arising from motor cycle crashes. This number is among 147 motorcyclists operated at MOI while there were 210 other cases, making the total number of operated cases 357.

Comparing in term of deaths recorded for April only, bodaboda operators were leading by 18 deaths, while cars caused three accidents and others victims were caused by other sources. According to him, motorcycle road crashes contribute to brain trauma injuries, mental confusion, long-term disabilities or deaths.

Dr Juma Mfinanga, Head of Emergency Medical Department (EMD) at the Muhimbili National Hospital (MNH), reveals that most casualties of motorcycle crashes admitted at the referral hospital suffer from brain trauma injuries.
Brain trauma, according to Dr Mfinanga, is one of the fatal risks that persons riding on motor-cycle without wearing helmets suffer in the event of a road crash.

“Head injury is a common cause of death and long-term disabilities after motorcycle crashes,” says Dr Mfinanga.
The national referral hospital admits between 30 and 50 road crash casualties per day with motorcycle crashes contributing 51 percent of the admitted total.

According to Dr Mfinanga, inter-cranial trauma injury is the leading, resulting from injuries suffered from motorcycle crashes, making 27.9 percent of all crash casualties.

The other form of injuries suffered includes long-bone injuries with 58 percent cumulatively. Similarly, a person riding a motorcycle without wearing a headgear is likely to face inter-cranial injuries when he is involved in a road crash.

However, Dr Mfinanga is more concerned with inter-cranial brain trauma saying road crash victims’ risk of losing consciousness, becoming crazy, mentally confused and sometimes mental illness.

“Brain is the driver of all activities in the human body, therefore once disturbed; a person’s judgment ability drops to zero”, he says.

Underscoring the importance of wearing helmets, Dr Mfinanga says: “The brain must be protected by wearing helmet to reduce inter- cranial trauma or internal bleeding, which in most cases causes permanent disabilities”.

Dr Mfinanga has a simple message to all stakeholders: “Concerted efforts from all stakeholders are needed to increase awareness on the negative medical impact of not wearing headgears by motorcycle riders”. He would like to see all motorcycle riders wearing helmets. It is time for behaviour change.

The medical doctor notes that out of road crash casualties operated in April this year, 52 involved head operations, which was equivalent to 35.4 percent. There were also 73 cases (49.7 percent) and 22 upper limb (14.9 percent).

Operations figures available at MOI are equally horrifying. The referral hospital operates between 25 and 35 road crash casualties per day mostly from motorcycle crashes. The admission figure is equally high ranging from 20 to 35 per day.
What worries, both medical experts and stakeholders is the fact that those maimed in motorcycle road crashes are people in the active productive group aged 21 and 40 years.

“Unless the government amends the helmet law to effectively increase and enforce its use, the number of victims associated with head injuries will double,” says Dr Mfinanga.

This is due to the fact that helmet use plays a big role in reducing risks of not only head injuries but also deaths.
Pointing out site of injuries, he said, head injuries are still leading by 31 percent, upper limb 14 percent, spinal cord 4 percent and lower limb 5 percent

Road crashes from whatever cause are levying a cruel tax to individuals, families and communities while causing a drain to the health budget.

When a family member becomes mental ill after a road crash, that results into not only frustration or mental confusion but it also means the victims cannot produce or be employed in any serious task and must depend on relatives or community for survival.

One of the victims, Hamad Mohamed, 36 years old from Mtoni Kijichi in Temeke Municipality depends on relatives and well wishers after sustaining serious injuries on top of his head and some parts inside of his mouth after a motor-cycle road crash in Mbande locality.

He admits that his family and relatives incur huge costs to meet treatment as well as taking care of him until his condition stabilises.

According to Dr Mfinanga in the past two years (2014/2015), the number of road casualties admitted at the National Referral Hospital have increased from 6, 225 to 8, 420 patients.

Equally interesting is that of all casualties admitted in 2014, 71 percent were from motorcycle road crashes. Likewise, out of those admitted in 2015, 72 per cent were motorcycle casualties.

When a comparison is made, motorcycle is leading by contributing 51 percent of road crashes. Regular cars contribute 27 percent, commuter buses 9 percent, bicycles 5 percent, bajaj 3 percent and long trucks 6 percent.
Medical data also reveal that motor-cycles contribute heavily in the increase of treatment bill to the over-stretched health facilities.

“Currently, the cost of stabilising one casualty ranges between 500,000/- and 1m/- depending on the severity of injury,” according to Dr Mfinanga.

He says for moderate injury cases, stabilisation takes from 6 to 14 days and for severe injuries cases it takes up 28 days. For private hospitals the cost is as high as 2m/- depending on the extent of severity.

Regarding overload on medical personnel, to stabilise one casualty; according to medical experts, there should be a team of not less than 7 people including three doctors and three nurses and a number of equipment such as ventilators, oxygen, medicine and special beds.

No wonder medical experts are agitating for review and enforcement of law on the helmet, saying on the wake of Bodaboda (a Kiswahili word for commercial motor-cycles) business, wearing of helmets must be enforced at any cost without fear or favour.

Global figures as provided by WHO in 2012, indicate that, each year 1.2 million people die as a result of road traffic crashes, and millions more are injured or disabled while head injuries remain the leading cause of death and disability among motor-cycle riders.

Equally important, in many low-income and middle income countries like Tanzania, use of motorcycles make more than 50 percent of those injured or killed on the roads. Likewise, the costs of head injuries are high because they require specialised medical care or long-periods of rehabilitation.

According to WHO, wearing helmet is singled as the most effective way of reducing head injuries and fatalities resulting from motor-cycle road crashes.

Experts point out that wearing of helmets decreases the risk and severity of injuries among motorcycle riders by about 70 percent and likelihood of death is equally cut by almost 40 percent. The practice also contributes substantially to reduce the costs of health care associated with road crashes.

“Since helmet use consistently has been shown to reduce motorcycle crash–related injuries and deaths. Therefore, the most effective strategy to increase helmet use is enactment and enforcement of laws,” medical experts argue
Dr Mary Kitambi from the Ministry of Health, Community Development, Gender, Elderly and Children, reveals that the government spends almost 3.4bn out of health budget set annually to treat accidents casualties.

Dr Kitambi, who is in charge of Emergency and Preparedness Unit, laments that the burden of treating road crash casualties is likely to double if measures are not taken to control reckless driving.

“Road crashes have also negative impacts on the social and medical point of view such as disability, phobias, social dependence, poor quality of life, depression, more funeral services and extra work to medical services,” says Dr Kitambi, adding that concerted efforts from the stakeholders is required to ensure the burden on treatment is also reduced.

According to Dr Kitambi, head injuries need expertise and high technology, which the government had to incur including training experts on more skills abroad of which leads to budget increase.

The medical doctor admits that her ministry was shouldering a huge treatment burden including cost of procuring equipment and medicines contrary to what it used to be in the past when the number of road crashes was still small.

According to reports by the Legal and Human Rights Centre (LHRC), road accidents in Tanzania are estimated to cost the country between 1-2 percent of the GDP per annum pointing out that Bodaboda (motor-cycles) accidents have become the major contributor of injuries and related fatalities to the people.

Henry Bantu, President of the Safe Speed Foundation, argues that there is an increase in road accidents due to big work load network. According to him road safety was not only the role of policy- makers but rather it is a collective role of all key players since they are part and parcel of road accidents by changing people’s culture on road usage .

“Currently, there are more than 1.4 motor vehicles registered in the country a figure, which is inversely proportional to the road capacity.” says Bantu.

Bantu believes the rate of road accidents can be contained if members of the public cooperate with traffic police and other authorities by observing traffic regulations and reporting offenders.

Figures from the Police Traffic Department show that there was an increase of motorcycle road crashes from 4,169 to 2,626 in the year 2014 to 2015 respectively. However, the statistics further reveal that despite a decrease in the number of accidents, death tolls increased from 928 to 934 people in 2014 to 2015 respectively.

Acting Police Traffic Commander, Fortunatus Musilimu notes that most motorcyclists observe no regulation, including simple ones such as observing traffic lights. There are those who ride without driving license, wear helmets and have no qualms about driving in the wrong direction including one–way direction.

Commander Musilimu would like to see increased community awareness on helmet use for Bodaboda riders and their passengers. There is also a need for enforcement and revival of road safety laws governing passengers and motor-cycle riders on helmet use.

According to him, motor-cycles are relative unsafe commercial means of transport, the operators must be considered also as unprotected motor-cycle user as their injuries are usually severe.

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