Solution-ing Cameroon’s rising car fatalities.

By Hinsley Njila – for www.chiareport.com

When Innocent Chia learned of a recent tragic car accident that took the lives of some 15 traders along the Tiko-Douala road, he called and asked me to write an article proposing solutions on that which needs to be done cost-effectively and locally to address this public health epidemic. He understood that it’s been some 20 years since my father – my hero - met his own untimely death along the same route. But I think most importantly Innocent trusts that my expertise in public health and finance will allow my proposal to be grounded in fact and logical reasoning.

Ever since I was a child old enough to not be shielded from the news of such fatalities, it just seems like the Tiko-Douala road has been a ‘death trap’’. In fact, it’s often referred to by locals as such. I know of countless people – young and old alike who’ve died along this road - including a few from the most recent horrific case. This is not a proposal designed to completely eliminate car accidents from happening in Cameroon. In fact the only country in the world without fatalities from car accidents last year according to WHO was San Marino. So as long as there are cars, there’s a likelihood there’ll be car accident fatalities – this is a proposal for a cost-effective grassroots solution. 

First - The facts
According to the World Health organization - WHO – Global status report on road safety 2013, Cameroon had about 443 thousand (443,000) registered vehicles in 2010 (year of most recent data). The country does have a national road safety strategy that is partially funded, it has national speed limit laws - which can also be set at local levels (max speed limit = 60km/h), national drink driving law, national motorcycle helmet law, national seat belt law, and law restricting the use of mobile phones while driving.

The trend in the number of traffic deaths has been increasing to record levels not seen since 2000. Cameroon loses about 3,512 people for every 100,000 cars every year which is 16th worse in the world and experiences 28.1 traffic fatalities for every 100,000 inhabitants – also one of the worst in the world. Some authors have cited 80% of accidents to be from operator error, but no reliable post-accident investigations are ever done to validate that number although we feel it can be quite that high or even higher. Why are things so bad on Cameroon’s roads, and how can we make them better?

The answer to the first part of that question is not so simple and straightforward. It involves a combination of factors and cofactors that include: lack of training, endemic corruption at the ministry of transport, prevalence of substance abuse among drivers – primarily alcohol, lack of law enforcement, over-speeding, poor roads, lack of any protection for pedestrians – all of which have been comprehensively presented in the referenced WHO report.

Our proposed solutions which we address in this article are outside the realm of solutions that WHO and others are pushing for and tracking progress on. Our approach emphasizes trust in people rather than institutions, private enterprise, and promotes empowerment and the power of citizenry in determining outcomes. Like citizens from other parts of the world, Africans must be trusted to make the right decisions that impact their lives when provided the right information. We are capable of doing just that.

People power
While WHO and other institutions have done a credible job of identifying a series of issues and proposed some credible solutions, it’s rather unfortunate that these are top down solutions whose successful outcomes rely almost too much on the competence of governmental institutions. For starters, maybe it is because it says road fatalities that the ministry of transport owns the strategy. But I happen to think the ministry of public health has to be the owner. This is a public health crisis with a major road component. In Chicago – the murder capital of the United States, we treat gang violence for instance as a public health crisis, not as a law enforcement problem. Gang violence is rampant in poor neighborhoods, with high levels of substance abuse problems, deteriorating schools etc. This is the public health connection that must be recognized and addressed head-on.

Secondly - A 2012 study by the Economist intelligence unit regarding the level of trust people around the world place in their institutions of government ranks Sub-Saharan Africans as having the least amount of trust in their institutions of power. Many of these institutions that include the army, police and ministry of transport are said to be too corrupt, and far too incompetent to deal with basic social issues. Are these the same institutions suddenly being tasked to enforce speed limit or mobile phone usage laws? 

The solution – go directly to the people

 There needs to be a comprehensive public health campaign targeting the population most at risk to die from traffic fatalities. Where are the ‘don’t drink and drive’ signs at bars, motor parks, or drivers’ manuals? I remember how aggressively the Ministry of Public Health took on the HIV/AIDS pandemic as it ravaged families and communities across the country. The Ministry of Health flooded the public airwaves with targeted ads for the use of condoms and or abstinence. Just like the early days of the HIV campaign, citizens need to be trusted and empowered to exercise their citizenry. Through well executed campaigns that include - radio, TV, internet and OOH, people most at risk can be reached at ‘njangi’ houses, local markets, schools, etc, and empowered to NEVER get in the car of a drunk, tired or erratic driver.

Citizens must be empowered with the courage to stand up to drivers who stay on their mobile phones while transporting passengers, and because 60 – 80% of fatalities involve pedestrians, and motorcyclists, let’s require our ‘bendskin’ drivers to start wearing helmets and drive slower, and ask our local mayors to create safe pedestrian crossings areas with manned crossing guards. Let it be required that to be a “bendskin” operator, you must have had a license and operated a motorcycle for a minimum one year.

It is definitely sad and true that locals are usually well aware of substance abusers who spend all night drinking at local bars then proceed to drive passengers in the morning, drive erratically or talk on their phones all the time. There is a cause-effect disconnect that must established so they understand the connection between that behavior of drinking, for instance, and the likelihood that driver will drive them to their death. People need to be empowered to say NO to getting in that guy’s car.

Should enough of us demand that our drivers be responsible by refusing to get in the car of the irresponsible drivers, market forces will speak and only responsible drivers will remain in business, thereby keeping the roads and us safer.

About five years ago, 3 of my relatives and I needed to travel from Yaoundé to Douala late one evening, so we decided to head to the station and buy tickets on a Guarantee Express bus. The bus must’ve left Yaoundé shortly after 6:00pm for Douala, and about an hour into our four hour journey the driver was driving at about 100km/h and falling asleep at the same time on a road where max speed is 60km/h. The silence on this packed 45 people bus became deafening, and I can remember just thinking it was going to end, especially since the road itself is littered with signs indicating fatalities at intervals that seem like every 1km. At one point I looked around and all I saw were frightened faces looking utterly confused.

I know my brothers and I said something to each other, but I was so overcome by fear that I cannot remember what was said. Suddenly I heard a lady scream at the top of her voice from the end of the bus in French ‘Please slow down driver, else you’ll kill us all” to which he replied ‘don’t worry you’re all protected’. At this point a bunch more people spoke out and told the driver to slow down and he finally heeded after arguing with them. I’ve never enjoyed getting somewhere more than when we arrived in Douala late that night. That lady saved our lives – she was the angel I never got the chance to thank. I believe in the power of our citizens to save their lives and be responsible for the lives of others. As some who have traveled this road know, there are so many police officers along this windy road, none of them stopped us to say enforce speed limit or seat-belt laws, but an ordinary citizen did, and I’m quite grateful for her courage.

Financial markets
Ultimately a long-term solution will have to include our financial markets, specifically from insurance companies. Glaringly obvious is the need for a strong financial system with insurance companies that development the kinds of actuary models that will discourage bad operator behavior. In other words – let’s say a company with a poor safety record has to pay insurance premiums so high they’d eventually get out of business – now that’s how the financial markets fix things.

If you own a bus company, your insurance company in order to provide coverage will eventually be able to mandate how much training your drivers should have, how many hours they can drive each day, how many passengers they can carry per trip, and how fast they can drive on the road. High risk drivers will be too costly to hire therefore they’ll be let go.

Ultimately, for a solution to have the kind of impact reducing the alarming numbers of car fatalities that exist on our roads, it will have to be comprehensive. Cameroonians must be involved in making decisions that save their lives, and ministry of public health must be charged with dealing with public health crises rather that the ministry of transportation. I feel for victims of the most recent Tiko-Douala road car fatality, but I hope their deaths and the 20th anniversary of my father’s passing will be the catalyst for the kind of bottom-up change we need.