GHANA: Road crash casualties hit maternal health efforts

Photo: Evans Mensah/IRIN

Crash on the road from Accra to Winneba, also known as Ghana's 'Bermuda Triangle'

ACCRA, 12 June 2009 (IRIN) - Doctors in Ghana have had to halt special prenatal home visits – part of an initiative to beat high maternal mortality – because road crash casualties are taking up so much of their time and scarce resources, medical workers say.

In March and April over 100 people died on one 15-kilometre stretch of road between the capital Accra and Winneba to the west, according to doctors at the Winneba government hospital. The area is known locally as “Ghana’s Bermuda Triangle”.

Road accidents are among the top causes of death in Ghana, with malaria, diarrhoeal and respiratory diseases, according to deputy director of the Ghana Health Service, George Amofa. Road accidents kill more Ghanaians annually than typhoid fever, pregnancy-related complications, malaria in pregnancy, diabetes or rheumatism.

“The situation is putting unbearable pressure on the health system, depriving us of resources that would have been channeled into dealing with other pressing health challenges,” Dodi Abdallah, a doctor at the Winneba hospital told IRIN.

“We are losing the battle against maternal mortality because of the sheer pressure of accident emergencies,” he said.

Winneba, 15km from Accra, has one of the highest maternal mortality rates in Ghana with an estimated 700 deaths per 100,000 live births. LINK The only hospital in town has two doctors and one surgical theatre with mostly obsolete equipment. Given the shortage of beds, many patients lie on the floor.

We are losing the battle against maternal mortality because of the sheer pressure of accident emergencies

“We devoted our limited resources to [improving maternal health],” says Abdallah. The hospital had begun an education campaign and launched house-to-house visitations to give antenatal care to women who refuse to go to hospital.

“But since the beginning of this year we have stopped the initiative, because we now attend to five road accident victims a day often with critical injuries, which means we devote all our scarce resources to that,” Abdallah told IRIN.

From January to March 602 people died in road accidents in Ghana, up from 399 in the same period in 2008. The Ghana National Road Safety Commission projects that some 2,400 people could die on the roads by year’s end. The annual average since 2000 has been 1,800.

Ninety percent of worldwide road accident fatalities occur in developing countries, with West Africa particularly at risk, according to a 2004 World Health Organization (WHO) report. (link) If current trends continue, road fatalities will be one of the top three causes of death in developing countries by 2020 says WHO.

Facts
	Between 2000 and 2007 Ghana recorded 91,562 vehicle crashes that claimed 14,489 lives – an average of 1,811 a year (Ghana National Road Safety Commission)
	Malaria by comparison killed 25,000 people in Ghana in 2007 (WHO)
	Globally road collisions kill 1.2 million people every year and are the leading cause of death for people aged 10 to 24 years old (WHO)
	One in five road traffic deaths are children under age 16 (WHO)

Preventable

Road Safety Commission executive director, Nobel Appiah, told IRIN what troubles him most is that these accidents are preventable, since most are caused by speeding or careless driving, according to a study released in June by the Ghana Road Safety Project (GRSP). The study indicates many drivers exceed the 50-kilometre per hour speed limit by as much as 50km.

Drunk driving is another problem. “We still have alcohol drinking spots at our bus terminals encouraging long distance drivers to drink before they set off,” Appiah said.

A daily long-distance driver, Stephen Mensah, admitted to taking several shots of hard liquor before starting a journey.

Defective roads, drivers’ failure to wear seat belts and corruption also contribute to the problem, said Appiah. “The most worrying problem is the police who often fail to enforce the laws because they prefer to take bribes from drivers. As a result innocent by-standers like children lose their lives,” he said.

Change

The administration of President John Atta-Mills recently met with transport sector stakeholders to draw up a national road safety plan, at the core of which will be tougher enforcement of road regulations, according to the Ghana National Road Safety Commission.

A new road regulation bill will soon be sent to Parliament to improve safety standards, including enforcing seat-belt use and banning mobile phone use while driving.

Police officers are to be assessed annually on performance targets, including whether or not they report road safety transgressions, Appiah told IRIN.

Winneba hospital doctor Abdallah said change cannot come soon enough. “Our hospital cannot cope with the number of accident victims who come in. There is nowhere else to send them. We are facing a daily crisis here.”

em/aj/np