9 December 2012

Uganda: A Boda Crash Could Cost You Shs 15 Million - Doctors

Think before jumping onto one, doctor advises:

When a major accident occurs, the police often remind the public to take measures to ensure safety, and often we ignore them.

But when accident survivors, such as Obed, share their ordeals, their audiences go silent. The testimonies are gory and heart-wrenching. Obed has been lying in Mulago hospital's Emergency Ward 3B for five days now, following a motorcycle accident. His head is severely damaged, still dripping blood and his swollen eye has blurred his vision.

Due to the inadequate 20-bed ward, Obed has been lying in the lobby, waiting for treatment.

"I don't know how I reached this place. All I remember is that the boda boda I was travelling on to go home collided with another," he says, under muted breath.

He then slightly lifts his body, smearing his face with blood as he tries to clean it; he then turns towards the wall, and rests. Compared to his first days, this is a good day, as he is able to rest most of the day. When I inquire, a nurse admits that since he arrived, Obed has only received first aid. Opposite him is Asiimirwe who is nursing a broken left leg from another traffic accident that involved a boda boda and a car.

Seemingly in less pain than Obed, he curses the introduction of boda boda in the country. Although he was not riding one on the evening of the accident, it was a boda boda that knocked him.

"I was attempting to cross the road when a cyclist cut into my calculated space from nowhere, and, in his attempt to manoeuvre through the slow-moving traffic, knocked me," the 20-year-old says, appealing for help.

Obed and Asiimirwe are part of the about 10 to 20 accident victims brought to Mulago hospital daily. Dr Robert Wamugoda, the clinical head of this unit, says at least three of the admitted cases die from severe head injuries and excessive bleeding, while some survivors are left disabled.

"Hardly any of these young motorcyclists wears protective gear, hence aggravating the risks of getting severe head injuries," he says.

The hospital is presently overwhelmed with an ever-increasing number of accident victims who cannot afford the cost of surgery. For instance, corrective surgery on a hip can cost at least Shs 15m, and a kneecap about Shs 12m, according to Dr Patrick Sekimpi, an orthopaedic surgeon at Mulago.

Sekimpi says this cost, which many can't afford, involves buying replacement implants.

"In case someone cannot afford surgery, we usually fuse the joints so that they become stiff and, for others, we give strong pain killers and walking aids like wheel chairs and crutches. These are done at no cost," Dr Sekimpi says.

This kind of treatment condemns one to a disability for life. Sekimpi and his colleagues perform 1,500 such surgeries every year, an indication of how serious the problem is. During the recent national road safety week, Mulago Executive Director, Baterana Byarugaba, admitted the hospital was overwhelmed by the accidents due to understaffing and poor remuneration.

"Delay for surgery is common and mostly due to shortage of anaesthetics, operating time and manpower," Dr Byarugaba said.

Dr Isaac Alidria Ezati, the director for Health Services in charge of Planning and Development, says ideal patient management eludes many patients because of the limited hospital ambulances. He also warns that pre-hospital care (within the first one hour of the accident) is critical and contributes greatly to victims' survival chances. But many victims don't get it.

Frugence Tunezerwe, an employee of Jag Security company, is another witness to the shortcomings of the healthcare system. Six hours after being rescued from the roadside with severe head injuries, he has only received first aid. The warmth of his fond bed has been replaced by a cold metallic one at Mulago because there is no spare mattress at the national referral hospital.

"He was brought here at 4am and up to now [10:06am] he has not received any serious medication. It seems we need to bribe so that he receives treatment fast," says Tunezerwe's friend, Silas Nkurunziza.

More accidents:

The latest annual traffic report from the Police shows that seven people die on the road every day on average. Of these, at least two have been on a boda boda. According to the registrar of motor vehicles, 73,788 motorcycles have been imported during the last five years. Consequently, boda bodas are almost taking over some streets.

Yet most riders are not well trained, leading to the high accident toll.

"Before you climb onto that boda boda, think carefully how expensive that ride could turn out to be," Dr Wamugoda warns.

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