ADDIS ABABA, 8 November 2011 (IRIN) - Improved access to
emergency medical care and compulsory third-party insurance coverage could help
to lower Ethiopia's high road-traffic accident death toll, say officials.
"At least one person dies out of [every] five car
accidents occurring in this country," said Bamlaku Alemayehu, inspector of
Ethiopia's National Road Safety Coordination Office. "Most of these
victims die due to a lack of proper medical services, such as getting immediate
medical assistance on time."
At least 70 people die in every 10,000 vehicle accidents
annually in Ethiopia, according to government reports; the average fatality
rate is 60 per 10,000 vehicles across sub-Saharan African countries, according
to the World Health Organization.
A study by a member of the Swedish Medical University of
Lund, Road Traffic Accidents in Ethiopia: magnitude, causes and possible
interventions, published in the Advances in Transportation Studies journal,
also suggests the numbers could be "in excess of 100 fatalities per 10,000
vehicles", noting that official statistics are susceptible to
under-reporting.
As of 2007-2008, Ethiopia had 95 traffic accident fatalities
per 10,000 vehicles, states a 2009 UN Economic Commission For Africa report.
According to the Lund study, inadequate communication to
immediately inform officials and hospital emergency services about traffic
accidents in rural areas is a problem, implying "that many accidents and
the number of victims cannot be registered".
Poor emergency medical services and the absence of
compulsory liability insurance laws are among reasons contributing to the high
fatality rates, it says, adding that "in the urban areas, although traffic
police and hospitals are available, accident victims are usually evacuated by
bystanders who [have] neither the necessary skills nor equipment in
pre-hospital care.
"And many of the victims are underprivileged people and
they can neither afford out-of-pocket payments nor do they have health
insurance to receive healthcare services, [thus many such casualties] are not
reported."
A poor road network and limited enforcement of existing
traffic laws and the poor condition of vehicles are other factors.
Under the National Road Safety Strategy Plan, launched in
July 2011, Ethiopia hopes to halve the fatality rate by 2020. The plan will tap
into more than 30,000 health extension workers, enabling them to provide first-aid
services to accident victims.
"These kinds of care-givers could save many lives
[lost] as a result of blood loss, since they are living within the
community," said Bamlaku.
The Ministry of Health is also expected to distribute some
800 ambulances to each Woreda (district), train paramedics and strengthen
health facilities at the Woreda level through trained emergency medical service
personnel.
"At the moment, the consequences of car accidents [are]
terrible considering the capacity of the country's medical services," he
said.
Insurance laws
Ethiopia is one of very few countries in the world where
third-party liability insurance is not a legal obligation. If and when they
become compulsory, such policies will provide compensation for road accident
survivors who can neither afford out-of-pocket payments nor health insurance.
"It might seem a bit late to start this kind of
mechanism compared to other countries but it's better late than never,"
said Byleyegn Bekele, spokesperson for the Insurance Fund administering the
compensation scheme.
A mix of revised laws that set a uniform standard in the
issuance of driving licences, empower organizations such as the federal
transport authorities and impose heftier fines for traffic violations could
also help, according to officials.
Over half of road traffic accident deaths in Ethiopia
involve pedestrians, of whom 20 percent are children younger than 18 years old.
Globally, at least 1.2 million people die on the road every
year, with low- and middle-income countries accounting for 90 percent of the
deaths, despite having only 48 percent of the world's vehicles, according to a
WHO global status report on road safety.
Nearly half of those killed are pedestrians, motorcyclists,
cyclists and passengers in public transport.
Ethiopian police records show that between 2003 and 2007, at
least 76 percent of fatal accidents were due to driver error, 6 percent due to
vehicle defects, 5 percent due to pedestrian error, 2 percent due to road
defects and the balance due to other causes.
"Unless the present trend is arrested, the social and
economic problem of road accidents is bound to become more and more serious as
the number of cars increases," warns the National Road Safety Strategic
Plan.
Road traffic accidents help perpetuate poverty as families
struggle with rehabilitation costs or funeral expenses after the loss of
breadwinners. The Lund University study noted that the accidents led to
"families being deprived or trapped by a cycle of poverty, in a country
where there are no social security services".
According to the study, pedestrians and passengers of
commercial vehicles were the most vulnerable in Ethiopia, whereas in
high-income countries accidents mainly involve private vehicles, with the
driver being the main occupant injured or killed.
WHO projects road traffic injuries will be the fifth-leading
cause of death globally by 2030.
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