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Story Publication logo January 14, 2014

Roads Kill: Traffic Accidents Take a Heavy Toll in Poor Countries

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Roads Kill

From HIV/AIDS to malaria and tuberculosis, poor countries endure more than their share of health...


It has a global death toll of 1.24 million per year and is on course to triple to 3.6 million per year by 2030.

In the developing world, it will become the fifth leading cause of death, leapfrogging past HIV/AIDS, malaria, tuberculosis and other familiar killers, according to the most recent Global Burden of Disease study.

The victims tend to be poor, young and male.

In one country — Indonesia — the toll is now nearly 120 dead per day; in Nigeria, it is claiming 140 lives each day.

This global killer is our most necessary accessory, the essential thing that gets us from here to there: the motorized vehicle.

Poor countries account for 50 percent of the world's road traffic but 90 percent of the traffic fatalities. The costs associated with these deaths are a "poverty-inducing problem," according to Jose Luis Irigoyen, a traffic safety specialist at the World Bank. "It's costing on average between 1 and 3 percent of GDP" in low- and middle-income countries, he said, an amount that can offset the billions of dollars in aid money that these countries currently receive.

In 2010, the U.N. General Assembly adopted a resolution calling for a "Decade of Action for Road Safety." The goal is to stabilize and eventually reverse the upward trend in road fatalities, saving an estimated 5 million lives during the period. The World Bank and other regional development banks have made road safety a priority, but according to Irigoyen, donor funding lags "very far below" the $24 billion that has been pledged to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

In "Roads Kill," The Washington Post joins with the Pulitzer Center on Crisis Reporting to bring stories from around the world about this neglected but easily curable public-health crisis.

— Tom Hundley and Dan McCarey


ABUJA — The green-and-white taxi sped through the intersection, ignoring the traffic policewoman officer and narrowly missing a red Honda Civic coming from the adjacent road.

"Wèr è!" — the word means "lunatic" in the Yoruba language — the policewoman screams at the offending driver as he steps on the gas and zooms away. She glares at the disappearing vehicle, powerless to do anything else — no ticket, no fine, nothing for Nigeria's reckless drivers who routinely act as though the law does not apply to them.

It's only 11:30 a.m. in Abuja, Nigeria's busy capital, and this policewoman is about to witness several more infractions.

In Nigeria, speed limits appear to be viewed as mere suggestions, lanes are flexible, driving against traffic is routine and if you are caught, a little money can make all your troubles go away.

Nigeria has the worst driving record in Africa: nearly 34 deaths for every 100,000 residents, according to a 2013 World Health Organization report. The Federal Road Safety Commission, the agency responsible for road safety administration in the country, blames most of these accidents on speeding. The country's notoriously poorly maintained roads, riddled with potholes, help ensure that Nigeria is among the most dangerous places in the world to drive.

"It is not just about drivers here not regarding the rules," says Afolabi Bakare, a taxi driver. "The truth is most of them do not even know the rules. How many people go to driving school before they get their driving licenses? To tell the truth, even me — I did not know how to drive very well when I got my driver's license."

"All you need to do is go to the office and 'settle' someone with about [31 dollars], and they do the license for you," he said. "You do not even have to be there for data capture. It's the Nigerian thing."

The federal government has endorsed various policies to deal with the menace of unqualified drivers and to rein in fake driver's licenses, but authorities have consistently fallen short on enforcement. People seem to always find a way around the system.

— Ameto Akpe


JAKARTA — "We're talking about the equivalent of a jumbo jet crash every week," said Mustapha Benmaamar, a transport specialist with the World Bank whose office in a sleek office tower floats high above the din and clamor of one of Asia's fastest-growing cities.

"When a jumbo jet crashes, it's big news," he continued. "But here, these people die in silence."

Each day, an average of 120 people die in accidents on Indonesia's roads — more like two jumbo jet crashes a week.

It's the word "accident" that bothers Benmaamar and other road safety professionals.

"You reach a tipping point when these deaths are perceived not as something accidental, but as a result of a problem that has to be tackled. Only then will you see the fatalities start to drop," he said. "Indonesia has not reached that point."

The first thing a visitor notices about traffic in Indonesia — and in other developing countries in Asia — is the sheer number of small motorcycles. There are now more than 60 million motorcycles on Indonesia's roads, compared with 8 million cars.

The spectacular surge in the number of motorcycles here began a decade ago, when the economy first opened up and easy credit became available to the masses. Motorcycles with sticker prices of $1,000 or so could be purchased for a little money down and a modest monthly payment.

In Jakarta, the crowded capital, swarms of buzzing motorcycles dart in and out and around the semi-permanent gridlock of cars and trucks and buses. They pop up on sidewalks and zoom insanely down one-way streets in the wrong direction. In a region prone to sudden downpours, they form flash mobs beneath overpasses, blocking traffic on main thoroughfares until the rain passes. Stop signs and red lights are not for them. Pedestrians get no respect.

This has produced an equally spectacular surge in the number of road deaths — from just over 8,000 a year in 2002 to more than 16,500 five years later and doubling again three years later. Sixty percent of the fatalities were riders of two- or three-wheelers.

— Tom Hundley


BOGOTÁ — Whipping through the crunch of midday traffic in the tiny taxi felt a bit like riding a fast-moving ball in a pinball machine. We zoomed right. Ping. We zoomed left, without the young driver giving any hint our sudden change of direction to the drivers alongside. Ping.

I tried to keep my eyes open.

Heading back downtown during the afternoon rush hour on a major roadway, a veteran driver watched the cars all around him and moaned about his daily challenge. Too many cars, he said. Too many drivers — and especially the ones driving taxis, who take too many risks, he said.

As he talked on, I noticed an ambulance parked in front of a crash on the other side of the roadway.

With improved economic times, Bogotá, Colombia's largest city, is awash in cars, traffic woes and public concerns. In turn, local officials have sought to show their eagerness to deal with problem drivers and to assure a worried public.

After a recent fatal crash that involved a driver allegedly under the influence of alcohol, Bogotá officials publicized the overnight arrests of large numbers of drunken drivers.

So, too, the recent killing of a DEA agent in Bogotá, the apparent victim of a criminal ring that used taxis to target clients in upper-income areas, brought on discussions about the need for better licensing of taxi drivers.

But in many ways, the situation today in Colombia has improved.

Government figures show that traffic-related deaths and accidents have significantly declined since the mid-1990s. But the marked progress appears to have leveled off in recent years. There were 7,874 traffic-related deaths in 1995, and the number fell to 5,502 in 2010. But there were 5,693 traffic-related fatalities in 2012, a 3 percent increase over 2011, according to news reports.

Reflecting the global push for driving safety, Colombian officials several years ago outlined an ambitious effort to tackle the leading causes of the nation's traffic-related deaths and injuries by 2016.

Their report singled out passengers and motorcyclists as accounting for 70 percent of the traffic-related fatalities annually and looked at measures to cope with the problem.

— Stephen Franklin


BAMAKO — I've gotten used to watching the city's scooters carry strange things as they weave between the cars and buses that clog the dusty, sun-baked streets.

I've seen a father driving with his daughter perched on the handlebars of his scooter while his wife clutched his waist, a sleeping baby strapped to her back. I've seen a teenage girl in a tank top drain a can of beer while she drove and then toss the empty container at a police officer. What I hadn't seen, until recently, was a scooter with an upside-down sheep, legs bound by twine, stuffed awkwardly into a large box on the moped's back rack. I did a double-take when the sheep baa-ed as it went by. My driver didn't seem to notice.

Bamako is a city of scooters, for better and often for worse. The motorbikes are cheap, fast and staggeringly fuel-efficient.

The primary appeal of a scooter, though, is its small size. Bamako's traffic is horrendous, and drivers can easily spend an hour or longer sitting uncomfortably in their cars as they slowly inch their way from one side of the city to the other. Scooters are different. Drivers — depending on their skill, bravery or stupidity — can try to maneuver the little bikes through the impossibly narrow gaps separating one honking car from another. When they succeed, Bamako's scooter drivers slash their travel time significantly. When they fail, bad things happen.

"I was hit by a bus," a businessman named Traore Sebou Tidiane said matter-of-factly. "I wasn't going very fast, thankfully, so all I got were some cuts and a broken arm. I've seen worse."

Many Malians have.

It easy to see why Mali's roads are so dangerous, especially for scooter drivers. Malian drivers are incredibly patient and courteous — cars and buses routinely stop to allow other vehicles to cut in front of them — but accidents are inevitable when so many cars are jammed onto the same narrow roads, particularly ones that don't have working traffic lights or street lights. Scooter drivers make things even riskier for themselves by rarely wearing helmets.

"I know I should wear one, but it's just too hot,"Awa Traore said as she loaded an impressively large stack of groceries onto the back of her scooter.

— Yochi Dreazen



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Health Inequities

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