Newspaper article International Herald Tribune

Africa's Trauma Epidemic

Newspaper article International Herald Tribune

Africa's Trauma Epidemic

Article excerpt

Billions of dollars have poured into the continent to fight killer diseases. But the most basic killer, injury, is neglected.

It was dusk and I was on my way home from Abeokuta, a vibrant city in southwest Nigeria. My driver had switched off the car's air- conditioning so I could open the windows and feel the breeze. He was weaving between potholes in the road when suddenly, the scene ahead changed.

A large truck had pulled out carelessly onto the road, knocking a car straight into the median.

That stretch of road is notoriously dangerous, not just because of traffic accidents but also because of armed robbers. It's for that reason that I suppressed my natural instinct to stop and help.

I was filled with guilt as we passed the wrecked car, because I knew that if the young man at the wheel had been badly injured, there was only a small chance that he would get the emergency treatment he needed.

I knew this because I am a trauma doctor and the founder of West Africa's first indigenous air ambulance service. Nigeria, a country of more than 170 million people, has no organized trauma response system and no formal training for paramedics. Injured people are often taken to the hospital in a car or minibus or draped across the motorcycle of a good Samaritan, sometimes several hours after the accident has occurred.

Even if the patient does reach a local hospital, it may not have the skilled staff or equipment needed. (There are only a few that do, and there are huge distances between them.) Most of those who are seriously injured probably bleed to death.

So I couldn't help it when, a few moments later, I said "Stop the car, please."

I grabbed one of our emergency response bags from my trunk and walked back. I tried to concentrate on the types of injuries the driver might have rather than how unsafe it was walking on that stretch of road, particularly in the evening. Was he bleeding? Was he conscious?

The crash scene had quickly attracted some of the people who typically gather around accidents in Nigeria. Bystanders were pulling the driver out of the car. Before long they were joined by a barefoot "prophet" in a white robe. No Nigerian accident scene is complete without a prophet who commands everyone to stand by while he loudly predicts that the patient will stop bleeding. The patient is often drained of blood by the time the prophecy is complete.

Sadly, these prophets are the best hope that many Nigerians have. Trauma has become a silent epidemic in Africa, an epidemic that will only spread as the economy grows. More and more Africans are buying cars and working in heavy and dangerous industries. At the same time, infrastructure is poor, safety laws lax, and cars badly maintained.

Sub-Saharan Africa has the world's fewest number of motorized vehicles but the highest rate of road traffic fatalities, with Nigeria and South Africa leading the pack. …

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