January 28
“If you were the mayor of Blantyre, what would you do to reduce the number of children injured on the city’s roads?”
This is the essay topic our final year medical students must write on during their paediatric rotation.
It’s not every day that you have to undersew a four-year-old’s temporal artery in the emergency department just to stop the immense amount of blood loss from the gruesome flap of skin that the minibus has ripped off her face. And that’s not the worst of it. A base of skull fracture. Swelling inside the head causing unconsciousness and active fitting.
Malawi apparently has more road accidents per car on the road than any other country on the continent. Although there’s not that many cars compared to the overall population (13 million people and growing by the day), the number of road accidents is alarming. All too commonly we see children coming in with smashed skulls, broken limbs, blown pupils and the like, often with no way of identifying them and no possibility of contacting their parents – you simply wait until the grape vine winds its way back to the victims home for the family to find out their child has been hospitalised. One day, two days, sometimes well over a week, despite the police searching high and low.
One is quick to blame the drivers. And let’s face it, they’re terrible. Swerving into oncoming traffic to turn a corner with no notion of indicating; driving at night with no headlights – mostly because they just don’t work; overtaking around blind corners over the crest of a hill without the slightest modicum of caution; minibuses braking without lights, stopping absolutely anywhere, mounting the curb to overtake congested traffic or belching fumes so thick you can’t even see the road in front of your car. And all this isn’t helped by a complete lack of any road signs or street lights or markings, traffic lights that don’t work (or when they do, are never paid any attention), potholes big enough to swallow your car forcing sudden and unpredictable swerving and no one to do any real enforcing of the laws.
Yet it’s not just the drivers or the roads that can be blamed for the carnage that we see. The lack of general awareness of almost all pedestrians is nothing short of mind-numbing, and for that one can only look towards the general education levels. People run out onto busy roads with absolutely no inclination that they have a 1 tonne vehicle travelling at 60km/h about to squash them into the bitumen, and if they do see you they usually give a somewhat incredulous look then continue on their merry way, making no effort at avoiding you. School children run mindlessly along the roads, oblivious to the dangers they constantly put themselves in until they are lying in an emergency department, yet their parents and guardians do nothing to stop them or educate them. Driving here is like playing a computer game, a constant stream of moving obstacles that often reduce your speeds to a crawl, although in this game you don’t get three lives until its game over.
So as the mayors of Blantyre, I think our medical students have a fair bit of material to work with in trying to solve this little problem.
