It is on a Monday in December, around 5pm. I am entering the Emergency department of the University Teaching Hospital of Kigali, famously known as CHUK. A very big hall with blue curtains on one side and a number of labeled rooms on the other.
In the center, I see an area called “Triage”, a small microphone with an office telephone hanged on the wall, and a desk with words “Reception”. I would have been seduced by the calmness and neatness of this place and call it a paradise if was my first time to be here.
In an instant, the mood changes. One nurse rushes to the microphone in the center. She yells very loudly into the microphone; “CODE BLUE IN ROOM 9”. She repeats the sentence 3 times and runs back into room 9.
After her, several other health personnel in white coats run to room 9. In the medical language ‘code blue’ is an emergency situation announced in the hospital in which a patient is in heart or respiratory arrest requiring serious attention of medical staff.
After 30 minutes in room 9, a young man in a white coat and donning other heavy clothing comes out and call the patient’s relatives inviting them gently in the corner of the room. With a very disappointed face, he is certainly announcing to them that their loved one had breathed her last.
In the language of medics, we call the process “Breaking Bad News”. She is another victim of a road traffic accident. In the eyes of the stranger I am, someone died. But in the eyes of someone, somewhere, a mother is dead. A lovely wife is gone, a devoted friend and loyal sister is deceased. Parents are grieving the loss of their daughter.
The numbers are high. Why are the measures not?
Death is unavoidable and for sure it will remain to be as such. Thousands of people have died inside the walls of ER, and people shriek everyday inside this dreaded milieu. But this is neither an excuse nor an explanation and shouldn’t bring us a comfort when someone had died because of something preventable such as an accident.
Annually, hundreds die of accidents in Rwanda. Thousands are admitted in the hospitals and many of them sustain permanent injuries due to road traffic accidents.
Globally, road traffic accidents kill 1.35 million people annually. The World Health Organization (WHO) classifies Rwanda among countries in the red zone with estimated 29.7 deaths per 100,000 people. In their “Global Status Report on Road Safety 2018”, the WHO estimates that in Rwanda, 3,535 people died of road traffic accidents in 2018 although 593 deaths were reported. According to the Rwanda National Police, motorcyclists are involved in 71% of total road traffic accidents.
A research done at CHUK in 2013, revealed that 94.7% of all victims are male with an average of 35.9. Cars were the most frequent vehicles involved followed by motorcycles. However, motorcyclists, pedestrians and cyclists were more likely to have grievous injuries.
Rwanda has introduced different strategies to reduce the number of road traffic accidents. Installation of speed governor in buses, annual vehicle check-up, wide and better roads are few of them. In addition to this, health system especially SAMU services (Emergency Medical Services) improved significantly. Undoubtedly, due to the above mentioned measures, incidences of road have reduced but not to a desirable number.
What else can be done?
Although our country had made progress with regard to health care of victims, more efforts are still needed in improving post-crash care. Road users should be educated on basic health support. This will enable them to recognize basic and most common life threatening injuries, to know what can be done and how/who to call.
The country’s EMS (Emergency Medical Services) should continue to be improved and reduce to the minimum the time an ambulance takes to arrive at an accident location despite traffic jams. Our EMS should use innovative ways such as data-driven ambulance parking, mobile apps to track the exact location of the accident to avoid delays.
Nobody checks your ethics and past, medical conditions or your psychology issues. As long as you have a driving license, you drive people around.
People count on doctors and nurses to treat them just as they count on drivers of buses, trucks and motorcyclists to transport them and their goods to their destinations safely. But holding a university degree in nursing or medicine doesn’t allow you to practice and treat patients. You need to be assessed that you are qualified morally, ethically and intellectually – to practice this profession.
So why does having only a driving license qualify you as a driver of a public bus, a truck or a motto?
Imagine someone with epilepsy who may have convulsions anytime, driving a bus with 100 passengers?
Imagine a drug abuser, a mental disorder patient, a psychopathy, or a serial killer allowed to be on a wheel of a public bus or a motto?
Lets’ imagine something simple. Imagine someone with eye disease, let us say myopia, driving a bus full of 100 passengers!
To cut a long story short, having a driving license gives you the rights to drive yourself. But if driving people and their goods is your job, you need more than that driving license.